American trypanosomiasis is a neglected tropical disease whose spectrum has not been quite understood, including the impact of Trypanosoma cruzi infection on the haematological parameters of different vertebrate hosts. Thus, this study was designed to compare the pattern of haematological changes induced by T. cruzi infection in order to identify possible species-specific differences among taxons. We also aimed at evaluating the use of this parameter as a tool for diagnosis during the acute phase, when symptoms are usually masked. For this purpose, we performed a systematic search on PubMed and Scopus databases to retrieve original studies published until August 2016. Thirty-one studies were selected using Prisma strategy, which were then submitted to data extraction and methodological bias analysis. Half of the studies showed that the number of erythrogram decreased in infected animals, indicating anaemia. In 68.2% of the studies, the total amount of leukogram values increased, suggesting infection. The main methodological limitations were insufficient information for T. cruzi strains identification, inoculation routes and parasitological characterization. Most of the mammalian species analysed showed the same pattern of haematological changes following T. cruzi infection, indicating that haematological parameters might direct the diagnosis of Chagas disease in the initial phase.
Currently, the types and distribution of the lesions induced in the central nervous system (CNS) by Trypanosoma cruzi remain unclear as the available evidence is based on fragmented data. Therefore, we developed a systematic review to analyse the main characteristics of the CNS lesions in non-human hosts infected. From a structured search on the PubMed/Medline and Scopus platforms, 32 studies were retrieved, subjected to data extraction and methodological bias analysis. Our results show that the most frequent alterations in the CNS are the presence of different forms of T. cruzi and intense lymphocytes infiltrates. The encephalon is the main target of T. cruzi, and inflammatory changes in the CNS are more frequent and severe in the acute phase of infection. The parasite's genotype and phenotype are associated with the tropism and severity of the CNS lesions. The methodological limitations found in the studies were divergences in inoculation pathways, under-reporting of animal age and weight, sample calculation strategies and histopathological characterization. Since the changes were dependent on the pathogenicity and virulence of the T. cruzi strains, the genotype and phenotype characterization of the parasite are extremely relevant to predict changes in the CNS and the neurological manifestations associated with Chagas’ disease.
RESUMENLa información básica sobre los perfiles hematológicos de los murciélagos es muy limitada y dispersa. Para este estudio, nos propusimos compilar la información disponible al respecto con el fin de establecer patrones derivados de su análisis. En los murciélagos, el valor medio de hematocrito se encuentra alrededor del 56%, el recuento de glóbulos rojos promedio es de 10 106/µl, el de glóbulos blancos 5,300 cel/µl, la concentración de hemoglobina 17 g/dL y el recuento diferencial de glóbulos blancos es 42% de neutrófilos, 54% de linfocitos, 2% de monocitos, 1% de eosinófilos y 1% de basófilos. La información existente corresponde a sólo 7.3% de las especies conocidas actualmente incluidas en el orden Chiroptera (1,116). En la literatura disponible no parece establecerse una distinción sexual de perfiles hematológicos. En la distribución de la fórmula leucocitaria de la mayoría de las especies estudiadas se observa un predominio linfocitario que recibe el nombre de “fórmula invertida” o “desviación a la derecha”, pese a que en algunas especies se puede observar una fórmula leucocitaria con predominio de neutrófilos, lo que se denomina en hematología humana “fórmula hacia la izquierda” o “fórmula tipo neutrófilo”. La variación en la fórmula leucocitaria de mamíferos se puede deber a factores funcionales y/o genéticos. La información disponible para 81 especies resulta escasa para un grupo tan diverso como el de los murciélagos, por lo cual no es posible establecer patrones claros e inequívocos. Investigaciones profundas y detalladas son primordiales para ello, a fin de identificar los factores asociados a la variación en los parámetros hematológicos.Palabras clave: Chiroptera, eritrocito, hematocrito, hematología, hemoglobina.ABSTRACTGeneral information on hematological profiles of bats is very limited and scattered. For this study, our goal was to compile the available information on this topic to determine the pattern, if any, derived from its analysis. In bats, the average hematocrit (Hct) level is around 56%, the average red blood cell count (rbc; erythrocytes) is 10 106/µl, the average total white blood cell count (twbc; leukocytes) is 5,300 cel/µl, the hemoglobin is around 17 g/dL, and the averages of differential white blood cell counts (dwbc) are 42% of neutrophils, 54% of lymphocytes, 2% of monocytes, 1% of eosinophils, and 1% of basophils. The available information for bats as a group corresponds only to 7.3% of the currently valid species (1,116). In the available literature, it does not seem to exist a sexual differentiation between hematological profiles. In the distribution of the leucocitarian formula of most species of bats included here it seems to exist an important proportion of lymphocytes, know as “inverted formula” or “right bias”, although in some species it seems to be an important proportion of neutrophils, known as “left bias” or “neutrophil-type formula”. In mammals, the variation in this leucocitarian formula depends on functional or genetic factors. The available information for only 81 species of bats is insufficient for a highly diverse group, thus it is not possible to establish currently unequivocal patterns. Further detailed and systematic research is of paramount importance, to finally determine accurate causes of these values and the maintanance of these trends. Key words: Chiroptera, erythrocyte, hematocrite, hematology, hemoglobin.
Acute Chagas disease (ACD) caused by Trypanosoma cruzi has emerged as a major food-borne disease in Brazilian Amazonia. For the first time, we characterized an outbreak of orally acquired ACD in Acre, in the forest community of Seringal Miraflores, affecting 13 individuals who shared the pulp of açai palm berries: 11 adults and two children (one newborn), all diagnosed by thick-drop blood smears. The fluorescent fragment length barcoding method, which simultaneously identifies species/genotypes of trypanosomes in blood samples, uncovered an unprecedented genetic diversity in patients from a single outbreak of ACD: T. cruzi TcI in all patients, mostly concomitantly with the non-pathogenic Trypanosoma rangeli of genotypes TrA or TrB, and TcI, TcIV, and TrB in the child. The patients presented persistent fever, asthenia, myalgia, edema of the face and lower limbs, hepatosplenomegaly and, rarely, cardiac arrhythmia. The clinical symptoms were not correlated to gender, age, or to trypanosome species and genotypes. The inferred SSU rRNA phylogenetic analyses of trypanosomes from humans, triatomines and sylvatic hosts included the first sequences of T. cruzi and T. rangeli from humans in southwestern (Acre and Rondônia) Amazonia, and the first TcI/TcIV sequences from Rhodnius spp. from Acre. The sylvatic transmission cycles of genetically different trypanosomes in landscapes changed by deforestation for human settlements and increasing açai production is a novel scenario favoring trypanosome transmission to humans in Acre.
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